The History Of Endometriosis

Endometriosis received its first mention 142 years ago when Karl Freiherr von Rokitansky, an Austrian pathologist, wrote about the condition in 1860. The pathologist referred to the condition in his writings as "adenomyoma." It is unfortunate that our understanding of the disease has not progressed very far since that time.

Abundant Theories

Researchers have abundant theories about the causes of endometriosis, but have yet to prove any of them. Some researchers subscribe to the backflow theory. This theory was developed by Dr. John Sampson in 1921. Sampson believed that "during menstruation, a certain amount of menstrual fluid is regurgitated, or forced backward, from the uterus through the fallopian tubes and showered upon the pelvic organs and pelvic lining."

A certain amount of evidence has been found to support Sampson's theory. Some of the most recent studies have indicated that just about all women experience retrograde menstruation to some degree and show signs of a tipped uterus. Yet, most of these women will never develop endometriosis. Sampson's theory also fails to explain why endometrial tissue has been found in the breasts, lymph nodes, skin, and lungs, among other places, nor does the theory explain the rare few cases in which men were found to have the disease.

Another theory, known as the transplantation theory, holds that endometriosis is spread by way of the circulatory and lymphatic systems by way of the blood stream. This explanation works to clarify the finding of endometriosis in a variety of locations throughout the body.

Transferred Tissue

The iatrogenic transplantation theory purports that endometrial tissue is transferred from its original site to the site of surgery. This type of transference is uncommon thanks to modern surgical advances, but even if the theory works to explain a certain type of endometriotic tissue, it fails to explain how the disease first developed in its original site.

Two doctors, Ivanoff and Meyer, developed a theory called Coelomic Metaplasia. This theory posits that "certain cells, when stimulated, can transform themselves into a different kind of cell." This explanation would serve to explain why the disease persists in the absence of menstruation. It would also explain the rare occurrence of the condition in men.

Early Evidence

Another promising research track is the hypothesis that endometriosis is hereditary. There is early evidence to show that patients who have endometriosis also have relatives with the condition. This theory has circulated since 1943, with the most current work being done at the University of Oxford.

Several other theories have also been explored and will continued to be examined until definitive proof is found for the causes of this elusive disease.